UPDATES AVAILABLE: Employer Action Required! Distribute Medicare Part D Notices by October 15, 2022

Group health plan sponsors must provide Medicare Part D “creditable coverage” notices prior to October 15, the start date of the Medicare annual enrollment period for Part D, Prescription Drug (more…)

Consolidated Appropriations Act Section 204 Prescription Drug Data Collection Reporting for Anthem

The next phase of the Consolidated Appropriations Act is the Prescription Drug Data Collection (RxDC) Reporting provision. The Consolidated Appropriations Act (CAA) requires reports to be submitted beginning December 27, (more…)

2021 MLR Rebates Will Mail in Early September

Applies to Individual, Small Group, Large Group Anthem groups and Individual members in 11 states will receive 2021 medical loss ratio (MLR) rebates this year. The MLR provision of the (more…)

US Departments Issue Final Regulations to Clarify Federal Process to Protect Against Surprise Billing

This update was originally published by Larry Grudzien. The U.S. Departments of Labor, Health and Human Services, and the Treasury today issued final regulations concerning standards related to the arbitration (more…)

FFM 2023 Training is Now LIVE!

This post was originally published by HealthSherpa. ACA Marketplace Training is now live for both new and returning insurance agents. Complete your certifications to ensure you are ready for the (more…)

2023 Affordability Percentage Set at 9.12 Percent

This update was originally published by Larry Grudzien. The IRS recently issued Revenue Procedure 2022-34, which significantly decreases the affordability threshold for ACA employer mandate purposes to 9.12 percent for (more…)

Will the New Transparency in Coverage Laws Help Contain Healthcare Costs?

On December 27, 2020, the No Surprises Act and the Consolidated Appropriations Act of 2021 were signed into law. The No Surprises Act placed limits and procedures for determining costs (more…)

HHS Releases Proposed Regulations on Nondiscrimination

This update was originally published by Larry Grudzien. Summary of the Proposed Rule Reinstates application to all Department of Health and Human Services’ administered health programs and activities. The proposed (more…)

Departments Issue Checklist for Surprise Billing IDR Process

This update was originally published by Larry Grudzien. The Departments of IRS, DOL, and HHS (the “Departments”) recently issued a checklist of federal independent dispute resolution (IDR) and related requirements (more…)

Carrier Updates Regarding the Transparency in Coverage Rules and Machine Readable Files

The “Transparency in Coverage” final rules passed on October 28, 2020, requires health insurers and group health plans to create machine readable files (MRF) and member friendly cost estimation tools (more…)

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